January 4, 2005

IS MEDICAL PROGRESS EVER?:

For deep depression, more sensitive electroshock (HILARY WALDMAN, 1/04/05, The Hartford Courant)

Shock treatment. The very name conjures up images of psychiatry's sometimes-regrettable past.

But the treatment that has become almost synonymous with Jack Nicholson's body convulsing barbarously in the movie One Flew Over the Cuckoo's Nest remains one of the quickest and most effective depression remedies in psychiatry's toolbox.

'Again and again people say, `I thought they didn't do that anymore,' '' said Dr. Robert Ostroff, director of the Electroconvulsive Therapy Center at Yale-New Haven (Conn.) Hospital.

But since the 1930s, when two Italian mental health practitioners discovered a safe way to produce brain seizures using electrical shocks, psychiatrists and researchers have continued to refine and improve the technique.

Since the 1980s, when medications in the Prozac family showed that altering brain chemistry can help people devastated by depression, electroconvulsive therapy has gained a stronger foothold in the psychiatric arsenal.

While anti-depressants work well for some people, they provide no benefit to as many as one-third of the patients who try them. Even when drugs work, they can take weeks to kick in -- too long for people whose despair is stirring suicidal feelings.

''Every article (that criticizes shock treatment) fails to convey how sick these people really are,'' Ostroff said.

The idea that seizures can help calibrate brain chemistry can be traced back to the asylums of the early 20th century, where clinicians noticed that people who had multiple epileptic seizures showed improvement in their symptoms of depression.

Posted by Orrin Judd at January 4, 2005 8:50 AM
Comments

My Wife worked at a major mental institution in NYC many years ago. She saw convulsive therapy used on some major depression cases (this was before SSRIs) and she said it was nothing short of miraculous. Of course like any other therapy it can be misued or abused. So it has a campaign against it, as do the SSRIs, which they do not deserve. What is needed is more science and less politics.

Posted by: Robert Schwartz at January 5, 2005 2:53 AM
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